摘要
目的探讨早期骶3神经电调节在大鼠脊髓损伤后神经源性膀胱治疗中的应用及可能作用机制。方法将45只雌性成年SD大鼠随机分为正常组、电针治疗组、电针对照组,每组15只。采用脊髓横断法建立大鼠神经源性膀胱的模型。电针对照组与电针治疗组造模成功后均进行电极植入;电针治疗组进行电调节治疗,1次/d,连续治疗4周;正常组常规饲养。3组大鼠在电针治疗组治疗4周后均行尿动力学测定,同时处死取材,采用免疫荧光定量PCR方法测定M_3受体mRNA表达水平。结果尿动力学结果显示在膀胱最大容量、膀胱漏尿点压、膀胱顺应性指标中,电针治疗组与电针对照组比较,差异有统计学意义(P<0.05)。荧光定量PCR结果显示,电针治疗组膀胱M_3R的mRNA含量明显高于电针对照组和正常组,差异有统计学意义(P<0.05或0.01)。结论早期骶3神经电调节可以明显改善脊髓损伤后神经源性膀胱储尿和排尿功能的恢复,其作用机制可能是电调节促进脊髓损伤早期膀胱逼尿肌组织中M3R的高表达,抑制逼尿肌纤维化,改善膀胱顺应性。
Objective To investigate the efficacy of early stimulation of sacral the 3 for treatment of neurogenic bladder in rats. Methods Forty five adult female SD rats were randomly divided into 3 groups with 15 in each： normal group （A）, sham stimulation group （B） and electro-acupuncture group （C）. The neurogenic bladder was induced by spinal cord transection and then the electrode was implanted in group B and C. Rats in group C received electric stimulation twice/d for 4w. The urodynamic measurement was performed after 4w in all 3 groups, the rats were sacrificed and the expression of M3 receptor mRNA in detru- sor tissue was measured by immunofluorescence quantitative PCR method. Results The urodynamic results showed that there were no significant differences in maximum bladder capacity, bladder leak point pressure, bladder compliance indicators be- tween group C and group A （P 〉0.05）, but there were significant differences between group C and group B（P〈0.05）. PCR results showed that the expression of M3R mRNA in group C was significantly higher than that in group A and group B（P〈0.01 or 〈0.05）. Conclusion The early sacral nerve electrical stimulation can improve the storage and voiding function of neurogenic bladder after spinal cord injury, which may be associated with up-regulation of M3R in detrusor tissue, inhibition of detrusor fibrosis and im- provement of bladder compliance.
出处
《浙江医学》
CAS
2013年第24期2158-2160,2175,共4页
Zhejiang Medical Journal
基金
杭州市科技局项目(20110833B15)
